Provider Demographics
NPI:1447681465
Name:PRIVY OASIS LLC
Entity type:Organization
Organization Name:PRIVY OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAAKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, PMHNP-BC
Authorized Official - Phone:833-667-7924
Mailing Address - Street 1:1230 N KIMBALL AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-4707
Mailing Address - Country:US
Mailing Address - Phone:833-667-7924
Mailing Address - Fax:
Practice Address - Street 1:1230 N KIMBALL AVE STE 130
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4707
Practice Address - Country:US
Practice Address - Phone:833-667-7924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-01
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX799735363LP0808X, 364SP0807X, 364SP0813X, 364SP0812X, 364SP0811X, 364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Single Specialty
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & AdolescentGroup - Single Specialty
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Single Specialty
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, CommunityGroup - Single Specialty
No364SP0811XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Chronically IllGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114264199OtherNPI
TX1447681465OtherNATIONAL PROVIDER GROUP NPI
TX336552Medicare PIN